Provider Demographics
NPI:1174123517
Name:NATIONAL EQUINE INSTITUTE OF GROWTH THROUGH HEALING, INC
Entity type:Organization
Organization Name:NATIONAL EQUINE INSTITUTE OF GROWTH THROUGH HEALING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:I
Authorized Official - Last Name:SAMUELSON
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:716-338-5350
Mailing Address - Street 1:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:GERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14740-0104
Mailing Address - Country:US
Mailing Address - Phone:716-338-5350
Mailing Address - Fax:
Practice Address - Street 1:4696 MAPLE GROVE RD
Practice Address - Street 2:
Practice Address - City:BEMUS POINT
Practice Address - State:NY
Practice Address - Zip Code:14712-9516
Practice Address - Country:US
Practice Address - Phone:716-338-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty